Some Doctors, Nurses Named in Tennessee Suit against Purdue Pharma Still Practicing

n its lawsuit against Purdue Pharma, unsealed last week, the state of Tennessee names a slew of Knoxville-area health care professionals who were part of what officials say was a drug marketing push that helped create the addiction crisis that plagues the state today.

Records: Purdue Pharma pushed pill-mill doctors to shell out OxyContin, hid evidence

Some voluntarily surrendered their licenses or had them revoked by the state — in some cases, not until after they faced criminal charges.

Others were put on probation with terms that included education about addiction and narcotics, or simply barred from pain management practices or prescribing controlled substances.

Named in the suit are:

More: Coverage of the Purdue Pharma lawsuit

Brandy Burchell, nurse practitioner, Knoxville. Burchell had been a registered nurse in Tennessee since 2001. From 2011-2012, at two different pain clinics, a Department of Health investigation found Burchell prescribed at least 13 patients controlled substances, narcotics and other medications “in amounts and/or for durations not medically necessary, advisable or justified for a diagnosed condition” — sometimes giving them monthly prescriptions exceeding 1,000 morphine milligram equivalents a day that included “multiple” short-acting opioids combined with high amounts of benzodiazepines. She prescribed least one patient 3,000 morphine milligram equivalents daily. When patients became addicted, the state said, she didn’t document, report or try to treat their addictions, and she also ignored signs they were selling their drugs to others. Her nurse practitioner certificate, valid since 2007, was revoked Nov. 20, 2017, and her registered nurse license was put on probation for two years.

Jamie Chiles Cordes, nurse practitioner, Rockford. Cordes got her RN license in Tennessee in 2000 and nurse practitioner certificate in 2009. Her RN license was reprimanded and nurse practitioner certification suspended in 2015, after she was indicted in 2014 for conspiring to illegally distribute controlled substances, to which she pleaded guilty. Purdue once designated her a “core” prescriber because of the high volume of prescriptions she’d written. In 2017, she surrendered her license.

Christina K. Collins, nurse practitioner, Knoxville. Collins’ nurse practitioner certificate, valid in Tennessee since 2007, was put on probation March 1, 2018, which barred her from practicing in a pain management clinic. The Department of Health said its investigation found Collins, who practiced in two pain clinics including one where she was supervised by Dr. Frank McNiel, overprescribed narcotics to 11 patients, in some cases a daily dose of more than 1,000 morphine milligram equivalents and a combination of multiple short-acting opioids and benzodiazepines.

But Collins’ witness, Dr. Christopher Vinsant, testified records showed each patient was being treated for a legitimate medical purpose, and the Board concurred. It cited her for not providing enough documentation, gave her two years of probation and let her keep her registered nurse license.

Opioid crisis: Three things revealed by Tennessee's lawsuit against OxyContin-maker Purdue Pharma

Dr. Allen R. Foster, Knoxville. Foster got a license to practice in Tennessee in 1999 and was an anesthesiologist but practiced pain management full-time from 2002-2007 at offices in Knoxville and Morristown. He closed the Morristown office in 2007 but continued to practice in Knoxville.

Foster’s license was temporarily restricted Dec. 24, 2010, after the Tennessee Board of Medical Examiners found he overprescribed narcotics “in amounts and for durations not medically necessary, advisable or justified for a diagnosed condition.” He didn’t order appropriate diagnostic tests and procedures, didn’t look at patients’ previous medical records, and prescribed to patients he knew were drug-seekers, the board said. The board also said Foster contributed to the death of a non-patient as a result of overprescribing narcotics to treat one of his patients’ for “back pain”; committed “gross malpractice” when performing a phenol block on a patient, leading to paralysis and nerve injury; and didn’t properly supervise two family nurse practitioners — Gwendolyn Noe and Eva Fields — who also were writing prescriptions for narcotics.

Foster was one of the state’s top prescribers, especially in high doses, and prescribed 1,049,199 OxyContin tablets between 1998-2017, 85 percent of them in doses of 40 milligrams or higher.

Foster’s license was revoked by the board on Jan. 27, 2012, for “unprofessional, dishonorable or unethical conduct,” in addition to Foster’s being “guilty of a crime” — health-care fraud and failing to pay income tax, for which he was sentenced to 12 months and one day of prison and three years of supervised release. He was ordered to pay $736,905.07 to Medicare, TennCare and the IRS in restitution.

Buffy Rene Kirkland, nurse practitioner, Maryville. Kirkland became a registered nurse in 1998 and a nurse practitioner in 2004 and worked in several area pain clinics. She was reprimanded and her license suspended in 2015 after the Tennessee Board of Examiners found her guilty of “unprofessional conduct.” She voluntarily surrendered both her registered nurse license and nurse practitioner certificate on May 11, 2017, after she was found guilty of crimes related to dispensing controlled substances at Breakthrough Pain Therapy Center in Maryville. The clinic had no medical protocols, exam tables or supplies; patients weren’t given physical exams and paid cash for narcotics, and some used or sold drugs in the parking lot.

Dr. Frank McNiel, Knoxville. The Board of Medical Examiners disciplined McNiel, licensed as a general practitioner in Tennessee since 1985, for inappropriately prescribing narcotics in 1994, but he and his wife — family practitioner Dr. Janet McNiel, also disciplined at the same time — appealed the action and, in 1997, both won. At the time, they co-owned the pain management clinic Bearden Healthcare Associates, where Frank McNiel supervised several nurse practitioners and where Janet McNiel still works.

From 2006-2016, Frank McNiel was one of Tennessee’s top prescribers of OxyContin, writing 15,196 prescriptions. He prescribed 1,655,940 tablets of the drug in that time frame and 3,350,167 between 1998-2017, nearly 80 percent 40 milligrams or higher. From 2006-2016, Janet McNiel was the eighth-highest prescriber of OxyContin in Tennessee.

On March 20, 2018, Frank McNiel voluntarily surrendered his license. The board, after reviewing patient records back to 2002, had disciplined him for inappropriately prescribing controlled substances, including writing prescriptions for patients out of his East Knoxville home after retiring from Bearden Healthcare Associates in 2012. McNiel said in an interview with the News Sentinel that he did not believe he acted inappropriately but had decided not to fight.

Janet McNiel, according to state records, is supervising physician for four nurse practitioners and two physician assistants as part of her practice.

Dr. Abdelrahman Hassabu Mohamed, Knoxville and Morristown. Licensed to practice in Tennessee since 1999, a neurologist with a specialty in pediatrics, Mohamed treated multiple patients from Jan. 2, 2012 to Sept. 26, 2016, at his pain management practice, Hamblen Neuroscience Center in Morristown. From 2006-2011, he was one of Tennessee’s top prescribers of OxyContin.

On Sept. 11, 2017, he pleaded guilty in the United States District Court for the Eastern District of Tennessee at Greeneville for one count of conspiracy to commit health care fraud and 10 counts of aiding or abetting the commission of health care fraud — all felonies. On Jan. 24, 2018, Mohamed voluntarily and permanently surrendered his medical license, but state records show no formal Department of Health action against him before then.

Teodora Neagu, nurse practitioner, Knoxville. The Tennessee Board of Nursing found Neagu guilty of overprescribing narcotics and placed her nurse practitioner certificate, valid since 2007, on probation Nov. 11, 2017. From 2008-March 2013, Neagu practiced at pain management clinic Bearden Healthcare Associates, supervised by Dr. Frank McNiel, who state records show “informed (her) that higher doses of opioids generally led to a greater degree of functionality and quality of life. Thereafter, (Neagu) prescribed controlled substances in adherence to Dr. McNiel’s philosophy.” The board found the prescribing itself, though, wasn’t medically justified and was “nontherapeutic.” Neagu cooperated with the state department of health “in gathering facts regarding other practitioners” at Bearden Healthcare Associates and was given five years of probation.

Alan Pecorella, physician assistant, Knoxville. Licensed as a physician assistant in Tennessee since 2011, Pecorella had his license revoked Nov. 19, 2014, after the Tennessee Board of Medical Examiners found he overprescribed narcotics. The board found that from January 2013 on, Pecorella prescribed controlled substances, including combinations of opioids and benzodiazepines, to a “substantial portion” of his patients, many with daily doses of 250 morphine milligram equivalents. In Tennessee in 2013 and 2014, he was in the top 50 prescribers of controlled substances.

In addition, he pleaded guilty to simple possession of a controlled substance Nov. 13, 2013, in the General Sessions Court for Sevier County, for which he was fined $750 and sentenced to 11 months, 29 days of supervised probation, including random drug tests. The board revoked his license for at least two years, and he’ll have to appear before the board’s Committee on Physician Assistants and undergo an evaluation before applying for a new PA license. If he gets one, he can’t practice in a pain management clinic or prescribe controlled substances.

https://www.knoxnews.com/story/news/health/2018/07/11/tennessee-purdue-pharma-lawsuit-doctors-oxycontin/772056002/